Recent Decisions
Ranjan v. Aviva General Insurance Company, 2026 CanLII 15058 (ON LAT)
Catastrophic Impairment Determination — Licence Appeal Tribunal
The applicant was found to have sustained a catastrophic impairment pursuant to Criterion 8 of the Statutory Accident Benefits Schedule.
The Tribunal accepted that the applicant’s psychological impairments met the legal test for catastrophic designation, significantly expanding access to medical, rehabilitation, and attendant care benefits.
The decision underscores the importance of carefully developed medical and expert evidence in complex psychological impairment claims, where catastrophic status has a profound impact on long-term recovery and support.
Harrison v. CAA Insurance Company, 2026 CanLII 10329 (ON LAT)
Attendant Care Benefits, Quantum Determination - Licence Appeal Tribunal
This proceeding concerned the appropriate quantum of attendant care benefits under the Statutory Accident Benefits Schedule.
The insurer had approved attendant care benefits in the amount of $716 per month. Following a contested hearing, the Tribunal preferred the applicant’s medical and functional evidence and determined that the reasonable and necessary quantum of attendant care was $1,879 per month, resulting in a substantial increase in the benefit.
The decision highlights the role of detailed functional evidence in establishing the level of assistance reasonably required following serious injury.
Marcantonio v. Li, 2025 ONSC 3303 (CanLII)
Threshold Established at Jury Trial — Ontario Superior Court of Justice
This action proceeded to a jury trial arising from a motor vehicle accident. Following the jury’s verdict, the trial judge determined that the plaintiff met the statutory threshold under the Insurance Act, having established a permanent and serious impairment.
The case reflects the evidentiary and legal complexity involved in proving threshold at trial in Ontario motor vehicle litigation, including the careful presentation of medical and functional evidence necessary to satisfy the statutory test.
Farooq v Unifund Assurance Company, 2025 CanLII 132416 (ON LAT)
Minor Injury Guideline Determination - Licence Appeal Tribunal
The Licence Appeal Tribunal determined that the applicant’s injuries were not predominantly minor and therefore not subject to the Minor Injury Guideline (MIG) limit under Ontario’s Statutory Accident Benefits Schedule.
The insurer had denied several treatment plans, maintaining that the applicant’s injuries fell within the MIG. Following a contested hearing, the Tribunal rejected the insurer's position and found that the applicant’s injuries warranted treatment outside the MIG framework.
The Tribunal ordered the insurer to pay multiple disputed treatment plans, including physiotherapy services, psychological services, and a psychological assessment, together with interest on the overdue benefits.
This decision underscores the importance of properly developing medical and functional evidence when challenging an insurer’s attempt to confine a claimant to the Minor Injury Guideline, which can significantly limit access to necessary treatment and rehabilitation.
Mekonnen v. Sonnet Insurance Company, 2025 CanLII 102182 (ON LAT)
Entitlement to Non-Earner Benefits - Licence Appeal Tribunal
The Licence Appeal Tribunal considered the applicant’s entitlement to Non-Earner Benefits (NEBs) under Ontario’s Statutory Accident Benefits Schedule following a motor vehicle accident.
The insurer denied the claim for NEBs and after reviewing the evidence, the Tribunal determined that the applicant was entitled to a partial payment of non-earner benefits, together with interest on the overdue benefits.
This decision highlights the evidentiary and legal considerations involved in establishing entitlement to Non-Earner Benefits, which are available to accident victims who suffer a complete inability to carry on a normal life as a result of their injuries.